Hazard Vulnerability Analysis in Healthcare: Achieving Accuracy in Our Assessments (Part 1)

Matthew Icenroad

As we close out the year, Matt reviews the importance of conducting risk assessments for healthcare facilities - HVAs.

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At the beginning of each year or planning cycle, healthcare organizations around the world conduct a Hazard Vulnerability Analysis (HVA) to understand their risks for natural, human and technological hazards. HVAs are risk assessments that ultimately help healthcare organizations identify risk factors and calculate risk scores for specific hazards. The Centers for Medicare and Medical Services (CMS) requires healthcare organizations to complete a risk assessment and document any mitigation measures for the hazards identified.

Completing this tool is a process of identifying specific risk factors in the effort to calculate a risk source score for specific hazards. Though many tools can be used to complete these analyses, Kaiser Permanente’s HVA tool is famous for being the “go-to.” As updates have been made to the tool over the years, organizations have created modified versions to suit their needs. Some have even expanded its use to other, more specific tools (e.g., Denver Children’s Tool).

We may have a tool in hand and the general knowledge of how to complete it, but the question still remains, how accurate can we be? Jensen Hughes is currently exploring the accuracy of healthcare risk assessment tools, the level of accuracy we can achieve in our assessments, and other tools and techniques the industry can utilize to be more accurate in our analyses.

Engaging with our healthcare partners across the country, we have identified many organizations that “shoot from the hip” on risk assessments and provide ballpark probabilities with little data to support their conclusions. At the opposite end of the spectrum are organizations that do a deep dive into the data to truly understand its historical and predictive probability. If the former approach does not meet the spirit of the assessment and the latter is too extensive, how do we find the middle of the road?

An approach used by Jensen Hughes is the Delphi Technique, originally developed by the RAND Corporation in the 1950s. The Delphi Technique is a systematic and qualitative forecasting method that involves the collection of opinions from experts through several rounds of questions. The technique relies on each expert utilizing their specialized knowledge on specific topics to forecast the outcome of future scenarios, predict the likelihood of events, or reach a consensus about particular topics.

With the Delphi Technique, a healthcare organization’s emergency management committee conducts a facilitated meeting to identify associated hazard risks. Through blind questioning, each member identifies their view on the probability and associated risks related to their functional area. Because their opinions remain anonymous, members are prevented from influencing each other.

Conducting a risk assessment is the first and foundational step in any effective emergency preparedness program. This blog post is the beginning of a series of articles exploring hazard vulnerability analysis and emergency planning processes in relation to the risk assessment, informed planning elements, and the accuracy and applicability of the assessment and process. In our next installment, we will dive into some details on the benefits and drawbacks of specific techniques.

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